Brandon Birg Park, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

8212530-1205 Issued in UT

Practice address

389 S 900 E
Salt Lake Clinic
Salt Lake City, UT 84102-2310

Phone

(385) 282-2000

NPI assigned

Jul 8, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

University of Utah School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Family Medicine

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Salt Lake Clinic Radiology

  • Body Imaging Physician
  • Salt Lake City, UT
  • NPI 1073642757
  NPD
• Ihc Health Services, Inc

  dba Memorial Clinic

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1508904947
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  dba Intermountain Health LDS Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1063675171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 S 900 E",
            "address_2": "SALT LAKE CLINIC",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 S 900 E",
            "address_2": "SALT LAKE CLINIC",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "385-282-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRANDON",
        "middle_name": "BIRG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "8212530-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Terrace Surgical Associates LLC
• Park Terrace Surgical Center LLC
• Albert H. Park, MD
• Alice Park
• Ashley Park
• Brittney Marie Park
• Chihyung Park, MBBS
• Gordon Sherman Park, MD
• Howard Y. Park, MD
• Kyoungsook Leah Park, AGACNP-BC

• Diagnostic Radiology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.